Utility of Ultrasound and Magnetic Resonance Imaging in Patients with Disorders of Sex Development Who Undergo Prophylactic Gonadectomy.
J Pediatr Adolesc Gynecol
; 29(6): 577-581, 2016 Dec.
Article
in En
| MEDLINE
| ID: mdl-27079912
ABSTRACT
STUDY OBJECTIVE:
To evaluate ultrasonography and magnetic resonance imaging (MRI) in identifying gonads in patients with disorders of sex development (DSD) who undergo prophylactic gonadectomy, and to assess the capacity of preoperative imaging to detect premalignant and malignant transformation. DESIGN, SETTING, ANDPARTICIPANTS:
Retrospective cohort at a tertiary referral center of 39 patients with DSD who underwent MRI and/or ultrasonography before prophylactic gonadectomy.INTERVENTIONS:
None. MAIN OUTCOMEMEASURES:
Identification of gonads on preoperative imaging.RESULTS:
Thirty-three patients underwent ultrasonography, which identified 54% (35/65) of gonads and 14 patients had MRI, which identified 41% (11/27) of gonads. There was no significant difference between imaging modalities in the proportion of gonads identified (P = .25). The proportion of pathology-confirmed dysgenetic gonads identified was higher on ultrasound compared with MRI (51% vs 8%; P = .02). There was no difference in the proportion of pathology-confirmed testes identified on ultrasound and MRI (54% vs 71%; P = .33). Eleven out of 39 patients (28%) were diagnosed with a premalignant lesion, and there were no distinguishing characteristics documented on imaging reports to suggest transformation. The only diagnosed malignancy in this series had imaging describing a "normal-sized ovary."CONCLUSION:
Ultrasonography and MRI identified 40%-50% of gonads in patients with DSD who underwent prophylactic gonadectomy, with no significant difference between the 2 modalities. Clinicians should, therefore, consider ultrasonography as a first-line imaging modality. Premalignant lesions were not detected on either imaging modality. The only malignancy was described as a "normal-sized ovary" which should raise concern in a patient with complete gonadal dysgenesis expected to have streak gonads.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Disorders of Sex Development
/
Magnetic Resonance Imaging
/
Ultrasonography
/
Gonadal Dysgenesis
/
Gonads
Type of study:
Diagnostic_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
En
Journal:
J Pediatr Adolesc Gynecol
Journal subject:
GINECOLOGIA
/
PEDIATRIA
Year:
2016
Document type:
Article